herpes type one concern

[jim in philly]

doctor

on thursday, 5 days after exposure i felt a sharp back pain and heat for 3 hours.  is this symptomatic of herpes?  the pain went to my legs the next day.  Today i am 8 eight days after exposure. if nothing shows up in the first 3 weeks, what are my chances for being in the clear?
the woman had no open sores or cuts or lesions in her mouth.  are my chances for contracting genital hsv1 significantly less if there are no lesion or sores in her mouth after receiving oral sex? i understand i have asked many questions, please take a moment to answer.  thank you

[H. Hunter Handsfield, M.D.]

Some initial herpes infections are entirely asymptomatc.  But in those with symptoms, the only symptoms are blisters/sores at the site of infection.  The symnptoms you describe do not suggest a new HSV infection in any way, shape or form.

First, there is a 50% chance you are already infected with HSV-1, since half the population has it from childhood.  If so, you are immune to catching it again.  Second, if your partner had no overt oral herpes, the odds of catching HSV-1 from any particular episode of oral sex probably is less than 1 chance in severalt housand.  Finally, as you suggest, if you don't develop genital blisters/sores within 10 days, you're probably home free--and definitely after no symptoms in 3 weeks.

In other words, you can relax.  This isn't anything to be worried about.

HHH, MD

[jim in philly]

thank you
i myself do not have HSV1 because i never developed cold sores in or around the mouth or oral herpes. if the person offering unprotected fellatio has hsv1 and no open sores or lesions and has had quite a few sex partners,in your professional opinion, what are my chances percentage wise of being home free.
i have not eaten well, lost 8 pounds in 8 days, and felt nausea

one last question, how often or likely is the transfer of hsv1 asymptomatic?
thank you again

[jim in philly]

i forgot to add that i have had no erections at all since that date
i am praying for a good prognosis

[H. Hunter Handsfield, M.D.]

Not having recognized cold sores doesn't mean you don't have oral HSV-1. There still is a 50% likelihood you have it. Among all people with HSV-1, fewer than 10% have known oral herpes.

I cannot estimate the likelihood of asymptomatic vs symptomatic genital herpes due to HSV-1.  But someone as concerned and frightened as you are almost certainly would notice genital sores if you were infected.  (Most asymptomatic cases are not truly asymptomatic. They involve people who don't care as much as you do and simply don't notice mild lesions.)

Your appetite problem, weight loss and erectile dysfunction are not due to herpes. Most likely they are psychological in origin, and I suggest you speak to your provider about that aspect. I suggest it out of compassion, not criticism. Genital herpes, especially with HSV-1, simply isn't worth the level of attention and fear you are showing.

I won't have any further replies. Continue to follow up with your PCP if you remain concerned.